This prospective study was undertaken to determine the accuracy of bedside clinical methods compared with fiberoptic endoscopic examination of swallowing (FEES) for detecting aspiration in acute stroke patients. Fifty patients underwent an examination of their ability to swallow 50 ml of water in 10-ml aliquots. Later their oxygen saturation levels before and after swallowing 10 ml of water were measured using a pulse oximeter. Oxygen desaturation of more than 2%, was considered to be clinically significant. All patients then underwent a FEES assessment by a speech therapist and were followed up during their inpatient stay for evidence of aspiration pneumonia. The oxygen desaturation test had a sensitivity of 76.9% and specificity of 83.3% (chi2 = 18.154, p = 0.00002), while the 50-ml water swallow test had a sensitivity of 84.6% and specificity of 75.0% (chi2 = 18.001, p = 0.00002). However, when these two tests were combined into one test called "bedside aspiration," the sensitivity rose to 100% with a specificity of 70.8% (chi2 = 27.9, p = 0.000001). Five (10%) patients developed pneumonia during their inpatient stay. The relative risk (RR) of developing pneumonia, if there was evidence of aspiration on FEES, was 1.24 (1.03 < RR < 1.49). We conclude that the oxygen desaturation test combined with the 50-ml water swallow test is suitable as a screening test to identify all acute stroke patients at risk of aspiration for further evaluation and management.

New technologies and the ubiquitous use of smartphones have opened the possibilities for more convenient, affordable, fast, and safe options in urban transportation. This has led to the emergence of mobility-on-demand (MoD) systems, such as Uber and Lyft, which aim to provide fast and reliable mobility that is catered to individualistic needs. At the same time, automated vehicle (AV) technology has advanced at an impressive pace. Corporations, such as Google and Tesla (1), have been in a race to develop a fully automated vehicle. The combination of these two promising technologies, known as automated mobility-on-demand (AMoD), has recently attracted interest among both researchers and industry (for example, Uber (2) has started testing AV programs in several states in the US).The term AMoD (3) designates a service similar to MoD or taxi, with the difference that vehicle operations are driverless. AMoD combines the benefits of MoD and AVs in several aspects. First, operational cost is drastically reduced, given the complete removal of driver labor costs and superior energy efficiency of AVs. Furthermore, negative externalities, such as emissions, travel time uncertainty, and accidents, may also reduce, as already observed for MoD (4) and for AVs (5). The latter also observes that AMoD will increase road network utilization, making it possible to transport more passengers with less congestion, with respect to privately owned cars. Fagnant and Kockelman (6) found that AV benefits would amount to between $2,690 and $3,900 annually per vehicle, incorporating decreases in insurance, parking costs, and traffic congestion.It is clear that AMoD is a disruptive technology that will deeply impact the transportation system. Most of the literature (7-11) has focused on the efficiency of AMoD and AVs, in terms of road movement and fleet management. However, only a handful of recent studies have shown the importance 758630T RRXXX10.

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Renal transplantation is a successful treatment for terminal renal failure in cats. However, in the initial clinical study, there was a frequent occurrence of obstruction of the implanted ureter at the bladder wall or stoma. This resulted in the use of a modified "drop-in" technique that had proved effective in the prevention of obstruction in five normal cats. When applied to renal transplant recipients, ureteral obstruction was reduced, but continued to occur. The modified "drop-in" technique was abandoned and replaced with a technique that apposed the cut edge of the ureteral mucosa to the torn edge of the bladder mucosa. This technique is recommended as it has prevented ureteral obstruction in six successive cases. Prevention of ureteral obstruction, and the required corrective surgery, markedly reduces patient morbidity and mortality, length of hospitalization, and expense to the client.

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The SF-36 and RQLQ are good for discriminating rhinitis patients from controls, but the former is poor for detecting changes in QOL. Both are inappropriate for mildly symptomatic patients. Each instrument measures non-overlapping halves of the measurable HRQL. For an assessment of the HRQL in persistent AR that is complete and responsive both instruments should be employed together.